The need for long-term medical care has been increasing in recent years and is projected to continue in the years ahead. With this increase, there is much concern about how to pay for the long-term medical care. Because of the potential drain on public funds, there is interest in identifying what circumstances motivate private purchase of long-term care (LTC) insurance and what options individuals have if they choose not to purchase LTC insurance. The goal of the proposed study is to develop, extend, and publish findings about the LTC insurance purchase decision. Specific aims of the proposal include: 1) Expand preliminary findings which suggest that family circumstances are influential in the original purchase decision, while price and income considerations become more important in the renewal decision. 2) Explore the relationship between LTC insurance and other products, such as Medigap, Medicare HMO, and retiree health insurance. 3) Explore the relationship between LTC insurance and care alternatives such as nursing home care and care giving at home. An understanding of the LTC insurance purchase decision is critical in ensuring continued access to long-term medical care for seniors. It will allow us to assess the potential for encouraging private purchase and will allow us to evaluate the appropriateness of public funding.